In the realm of neurodevelopmental disorders, Attention Deficit/Hyperactivity Disorder, or ADHD, has long been associated with the image of a restless young boy fidgeting in his seat, struggling to focus on his schoolwork. This stereotype has perpetuated the persistent myth that ADHD is primarily a ‘boys’ disorder. Yet, the reality is far more complex and nuanced. While boys are indeed diagnosed with ADHD at a higher rate than girls, the notion that it exclusively afflicts males is a MYTH. (which we debunk here) Girls and women grapple with ADHD too, but their experiences often go unrecognized, overshadowed by outdated stereotypes. To truly understand ADHD and its impact, we must debunk this myth and shine a light on the unique challenges that girls and women with ADHD face. In doing so, we can pave the way for better recognition, support, and empowerment for this often overlooked group.

ADHD significantly impacts the quality of life for people and this impact can be particularly pronounced in women and girls, in part due to the damaging societal stereotypes applied to women in general. To understand the negative quality of life caused by ADHD specifically focused on ladies let’s explore some key aspects of the female ADHD experience:

• Academic and Occupational Challenges: For girls and women with ADHD, difficulties in concentrating, staying organized, and managing time can hinder academic and professional success. They may struggle to complete assignments, maintain focus during classes or meetings, and meet deadlines. This can lead to underachievement, reduced self-esteem, and missed opportunities.
• Social and Interpersonal Relationships: ADHD can affect one’s ability to maintain healthy relationships. Impulsivity, forgetfulness, and difficulty listening can strain friendships and family ties with varying levels of strain based on cultural, gender based norms. Girls and women with ADHD may experience frequent misunderstandings, forget important commitments, or interrupt conversations, making it challenging to establish and sustain meaningful connections.
• Mental Health: The emotional toll of managing ADHD can contribute to anxiety, depression, and low self-esteem. Constantly feeling overwhelmed, forgetful, or unable to meet one’s own expectations can lead to a negative self-image and mental health struggles. Women and girls with ADHD may also face a higher risk of co-occurring conditions like eating disorders, self-harm and drug abuse in an attempt to self medicate.
• Self-Identity and Self-Worth: ADHD symptoms can lead to feelings of frustration, guilt, and shame. Girls and women may internalize socio-cultural expectations and perceive themselves as inadequate or “different” due to their difficulties in maintaining focus or organization. These negative self-perceptions can erode self-confidence, hinder personal growth and begin cycles of executive dysfunction.
• Physical Health: Poor impulse control associated with ADHD can contribute to risky behaviors such as substance abuse, reckless driving, or unhealthy eating habits. These behaviors can negatively impact physical health and increase the risk of accidents or health problems.
• Long-Term Outcomes: Without proper recognition and support, girls and women with ADHD may face long-term consequences such as academic underachievement, career setbacks, and financial difficulties. These challenges can persist into adulthood, affecting overall quality of life.

Historically, ADHD has been more commonly diagnosed in boys and men than in women and girls. According to the Centers for Disease Control and Prevention (CDC), boys have been diagnosed with ADHD at nearly twice the rate of girls, probably because of all the gender bias happening during the diagnosis process (more on that later!). In young men, ADHD often presents with more externalizing behaviors, such as hyperactivity and impulsivity. Boys may showcase a range of symptoms like restlessness, fidgeting, interrupting others, and difficulty waiting their turn. Boys may also display aggression I.E. physical confrontations, which can lead to earlier recognition and diagnosis. 

ADHD in girls however, due to differing sociological factors, is much more likely to present itself as inattention as opposed to hyperactivity. Girls are much more likely to exhibit symptoms involving difficulty with focus, organization, time management, and following instructions. (We think boys might also suffer from difficulty managing their time but, for some reason no one is focused on if boys know how to do this! Could this be gender bias again?) Women and girls also usually internalize their symptoms, resulting in feelings of low self-esteem, anxiety, and depression. Women and girls may also engage in daydreaming or becoming forgetful, as opposed to their more obviously disruptive male counterparts, loudly picking fights in the lunchroom, and is therefore harder for concerned adults to spot, which can lead to diagnostic challenges.

Let’s debunk some of those diagnostic challenges now! You might have guessed that we would hit this point based on our somewhat sassy asides but, gender based stereotypes and societal expectations can and do influence how ADHD is perceived. Women and girls are often expected to be more organized, attentive, and compliant, making their struggles with ADHD less conspicuous and potentially overlooked. There is lower tolerance in society for hyperactive little girls and so they hide or “mask” these behaviors and their ADHD manifests itself in different ways. “Masking” can look like working harder, avoiding risks, or seeking support from friends. While these adaptive strategies look great on the surface, they can also delay diagnosis because the girls in question appear to be functioning well on the surface. Due to these differences in presentation and societal expectations, women and girls with ADHD are at risk of being underdiagnosed or diagnosed later in life which can lead to greater instances of self medication and other problematic coping strategies because women and girls may not be receiving the timely support and interventions they need. Delayed diagnosis can lead to missed opportunities for early intervention, academic and career achievements and improved quality of life. 

Recognizing and supporting ADHD in women and girls often requires a nuanced approach due to differences in presentation and societal expectations. In order to make sure your girls are receiving the proper care and accommodations they need, make sure you’re keeping a sharp eye out by educating yourself (with blogs like this one!) encouraging healthcare providers to stay informed about the gender differences in ADHD presentation and diagnosis (feel free to educate your child’s healthcare providers. Who knows what doctors are doing in their spare time.) and regularly screen your child for ADHD especially your young ladies. Use comprehensive assessments that consider both inattentive and hyperactive symptoms. Gather information from multiple sources including experienced teachers, fellow parents and your child. Challenge stereotypes and biases surrounding ADHD and get your daughters the care they need, deserve and are entitled to.